Does COVID-19 restrictions affect the detection and management of
ectopic pregnancies?
Abstract
Objective: To assess impact of COVID-19 on diagnosis and management of
ectopic pregnancy.Design: Retrospective comparative analysis of ectopic
pregnancies (EP) between January and July in 2019 (pre-COVID) and
2020.Setting: Performed at Blackpool Victoria Hospital, a district
general hospital in Lancashire. There were no changes in health care
personnel and EP management guidelines during both periods, however
service provision was modified in line with COVID-19
regulations.Population: We identified 27 EP cases of 1780 total
pregnancies presented to early pregnancy unit (EPU) in 2019 compared to
22 cases of 1782 pregnancies in 2020.Methods: Data was collected from
EPU computerised database, looking at maternal age, site, side, size and
gestation at diagnosis, ruptured EP, different management options. A Chi
square statistical analysis compared the variables.Main outcome
measures: Gestation at diagnosis and cases of ruptured EP. Secondary
outcome measures were the different management options.Results: The
incidence of EP cases was similar in 2020 and 2019 (22/1782; 1.23% Vs
27/1780; 1.51%, P=0.512). We found more cases of ruptured EP in 2020
compared to 2019 nonetheless statistically insignificant (6/22; 27.3%
Vs 5/27; 18.5%, P=0.467). However, a stark difference noted was the
gestation of EP diagnosis, 77.3% presented late (>6wks
amenorrhoea) in 2020 compared to 2019, proving to be statistically
significant (17/22; 77.3% Vs 25/27; 92.6%, P<0.001). Other
parameters like maternal age, site and size of EP, and different
management options; were not statistically significant.Conclusions: We
urge women to seek help as there are infection prevention measures in
place, to provide the services required in early pregnancy.